Active NPI
James William Cobb Jr., O.D.
- Optometrist
- Palm Bay, FL
National Provider Identifier
1568466803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC 974
- Practice address
- 2186 Harris Ave NE
Ste 1
Palm Bay, FL 32905-4044 - Phone
- (321) 724-2020
- Fax
- (321) 724-9088
- NPI assigned
- Jun 1, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC 974 | FL | Primary |
Addresses
Primary practice location
2186 Harris Ave NE
Ste 1
Palm Bay, FL 32905-4044
Mailing address
2186 Harris Ave NE
Ste 1
Palm Bay, FL 32905-4044
Phone (321) 724-2020
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 048031001 | Other | FL | DMERC |
| 7147100 | Other | FL | CIGNA |
| 4497605 | Other | FL | AETNA PPO |
| 084742900 | Medicaid | FL | |
| 19549 | Other | FL | BLUE CROSS BLUE SHIELD |
| 580098649 | Other | FL | RAILROAD MEDICARE |
| 625580 | Other | FL | AETNA HMO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC 974 | FL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198800000000",
"number": "1568466803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2186 HARRIS AVE NE",
"address_2": "STE 1",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329054044",
"telephone_number": "321-724-2020",
"fax_number": "321-724-9088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2186 HARRIS AVE NE",
"address_2": "STE 1",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329054044",
"telephone_number": "321-724-2020",
"fax_number": "321-724-9088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COBB",
"first_name": "JAMES",
"middle_name": "WILLIAM",
"name_suffix": "Jr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-01",
"last_updated": "2007-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC 974",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "048031001",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "7147100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "4497605",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "084742900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "19549",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "580098649",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "625580",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.